The severity of clinical manifestations in CBPS is correlated with the extent of cortical involvement. Most patients with CBPS have a history of speech delay or language difficulties and no epilepsy. Dyslexia can be found in patients with PMG.
the results of the study suggest that the assessment of children with epilepsy is necessary to investigate specific deficits that require appropriate professional assistance. Regarding the presence of oral language and/or writing disorders in these children, academic, social and emotional deficits can be avoided. The prognosis of epileptic syndrome does not exclusively depend on the control of the crises, since social or cultural problems can interfere in life quality as much as the crisis.
Objective: Although benign epilepsy with centrotemporal spikes (BECTS) is an idiopathic, age-related epilepsy syndrome with favorable outcome, recent studies have shown impairment in specific neuropsychological tests. The objective of this study was to analyze the comorbidity between dyslexia and BECTS. Method: Thirty-one patients with clinical and electroencephalographic diagnosis of BECTS (group A) and 31 paired children (group B) underwent a language and neuropsychological assessment performed with several standardized protocols. Our findings were categorized as: a) dyslexia; b) other difficulties; c) without difficulties. Our results were compared and statistically analyzed. Results: Our data showed that dyslexia occurred in 19.4% and other difficulties in 74.2% of our patients. This was highly significant when compared with the control group (p,0.001). Phonological awareness, writing, reading, arithmetic, and memory tests showed a statistically significant difference when comparing both groups. Conclusion: Our findings show significant evidence of the occurrence of dyslexia in patients with BECTS.Keywords: epilepsy, rolandic, dyslexia, childhood, BECTS. RESUMOObjetivo: Apesar da epilepsia benigna da infância com espículas centrotemporais (EBICT) ser uma síndrome epiléptica considerada idiopática, idade-relacionada e de evolução favorável, estudos recentes têm mostrado que essas crianças apresentam prejuízo em testes neuropsicológicos específicos. O objetivo desse estudo foi analisar a comorbidade entre EBICT e dislexia. Método: Trinta e um pacientes com diagnóstico clínico e eletrencefalográfico de EBICT (grupo A) e 31 crianças pareadas (grupo B) foram submetidos à avaliação neuropsicológica e de linguagem com vários protocolos estandardizados. Nossos achados foram categorizados em: a) dislexia; b) outras dificuldades; c) sem dificuldades. Nossos resultados foram comparados e analisados estatisticamente. Resultados: Os dados mostraram que dislexia ocorreu em 19,4% e outras dificuldades em 74,2% dos nossos pacientes. Esses números foram altamente significativos quando comparados com o grupo controle (p,0,001). Consciência fonológica, leitura, escrita, aritmética e testes de memória mostraram diferença estatisticamente significante quando foram comparados os dois grupos. Conclusão: Nossos dados mostraram que há evidência da ocorrência de dislexia em pacientes com EBICT.
This paper aims to describe the performance of the pretemporal craniotomy performed didactically from 2002 to 2012 in eighty patients. It is therefore a fundamentally descriptive text, organized in the sequence of the main stages in which such a craniotomy is performed, and describing in detail the technique with which this group of evolutionarily authors came to accomplish the task.
Background: perisylvian syndrome refers to a variety of clinical manifestations associated to lesions in the perisylvian or opercular regions. Polymicrogyria is the most common structural malformation found. The syndrome may be inherited and the clinical spectrum includes subtle language disturbances on one end and more severe characteristics such as prominent pseudobulbar signs and refractory epilepsy on the other end. Other studies have already associated perisylvian polymicrogyria with developmental language disorders or specific language impairment. Aim: to describe the language deficits of four members of a family with Perisylvian Syndrome, and to correlate these deficits to neuroimaging data Method: the patients underwent neuroimaging investigation, psychological assessment using the Weschler Intelligence Scales, and specific speech-language evaluation. The following tests were used for the assessment of vocabulary, phonology, syntax, pragmatics, reading and writing: Thematical Pictures of Yavas, ABFW -Child Language Test, Peabody Picture Vocabulary Test (PPVT), and other specific protocols. Results: magnetic resonance imaging revealed perisylvian polymicrogyria in all of the subjects, with varied locations and extensions. Speech-language assessment indicated significant oral and written language deficits in all of the subjects. Conclusion: the obtained data indicate that language impairment can co-exist with reading deficits in members of the same family. Neuroimaging findings reveal cortical alterations that are associated to specific language impairments within the spectrum of the Perisylvian Syndrome. Another important aspect evidenced by this study is the similarities in the language profiles of siblings and mother, suggesting that a variety of linguistic manifestations exist within the spectrum of the syndrome. Perisylvian polymicrogyria can be one of the neurobiological malformations involved in the manifestation of these deficits. Key Words: Language Development Disorders; Learning Disorders; Nervous System Malformations. ResumoTema: por Síndrome Perisylviana entende-se toda e qualquer manifestação clínica decorrente de lesão ou malformação que comprometa a região da fissura de Sylvius, sendo a polimicrogiria a alteração estrutural mais encontrada. A referida síndrome pode ser familiar, sendo que o espectro clínico pode variar desde manifestações leves de distúrbio de linguagem, até quadros extensos que cursam com proeminentes sinais pseudobulbares e epilepsia refratária. Estudos já correlacionaram a polimicrogiria perisylviana com a ocorrência do Distúrbio Específico de Linguagem. Objetivo: o objetivo desse trabalho foi descrever as alterações de linguagem em quatro membros de uma família com Síndrome Perisylviana, e relacioná-las a exames de neuroimagem. Método: os sujeitos foram submetidos a exames de ressonância magnética, à avaliação psicológica, por meio das Escalas Wechsler de Inteligência e à avaliação fonoaudiológica específica de linguagem. Para avaliação do vocabulário, fonologia...
Congenital bilateral perisylvian syndrome (CBPS) presents with heterogeneous clinical manifestations such as pseudobulbar palsy, language disorder, variable cognitive deficits, epilepsy, and perisylvian abnormalities (most frequently polymicrogyria) on imaging studies. We investigated the relationship between seizures and extent of gray matter (GM) and white matter (WM) abnormalities using voxel-based morphometry (VBM) of brain magnetic resonance imaging (MRI) as well the association between seizures, structural abnormalities and cognitive ability. In this cross-sectional study, we evaluated 51 healthy volunteers and 18 patients with CBPS with epilepsy (seizure group, n = 7) and without (non-seizure group, n = 11). We used VBM (SPM8/DARTEL) to investigate areas with excess and atrophy of both gray and white matter, comparing groups of patients with controls. Intellectual ability of patients was assessed by the WISC-III or WAIS-III. Both groups with CBPS and the control group were homogeneous with respect to gender (p = 0.07) and age (p = 0.065). Besides perisylvian polymicrogyria, the seizure group exhibited areas with GM and WM reduction including temporal, frontal, parietal and occipital lobes. In contrast, we identified fewer areas with GM and WM reduction in the non-seizure group. The seizure group presented worse intellectual performance (performance IQ and global IQ) than the non-seizure group. The seizure group presented with a more widespread pattern of cortical and sub-cortical abnormalities, as well as worse cognition. Our results suggest that patients with CBPS and epilepsy appear to have widespread neuronal damage that goes beyond the areas with MRI-visible perisylvian polymicrogyria.
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